Just because tests and treatments are available doesn’t mean we should always use them, says CMC chair Dr Derek Sherwood.
He points to X-rays for people with back pain as among the tests that need to be considered carefully before use. Back pain is one of the most common reasons we visit the doctor. But evidence shows most of us recover without needing scans or other tests.
“Not only do X-rays and CT scans expose patients to potentially cancer-causing radiation but many studies have shown scans frequently identify things that require further investigation but turn out to be nothing. This means patients can undergo stressful and potentially risky follow-up tests and treatments,” he says.
The reasons why unnecessary interventions occur vary. Dr Sherwood says common factors across countries include lack of consultation time, fear of missing a diagnosis, malpractice concerns, financial incentives and the challenge of telling patients they don’t need specific tests.
“The result can be care for patients that adds little or no value and may cause harm.”
Unnecessary prescription of antibiotics is among the starkest illustrations of no-value, high-risk interventions. Over-use of antibiotics is a major factor in antibiotic resistance, a global problem that could see a rise in antibiotic-resistant superbugs.
Latest figures show antibiotic consumption in New Zealand jumped 49 percent between 2006 and 2014. Data suggest our use is comparatively high by international standards. In 2013, New Zealand’s antibiotic consumption was higher than 22 out of 29 countries surveyed by the European Centre for Disease Prevention and Control.
Research published this year by the Institute of Environmental Science and Research reported a large number of antibiotics may also be prescribed where there’s no clear benefit, such as for treating seasonal colds and flu. Colds and flu are caused by viruses, not bacteria that antibiotics are designed to kill.